PARATHYROID LEVELS ASSESSMENT AND ITS ROLE IN EARLY DETECTION OF HYPOCALCEMIA POST TOTAL THYROIDECTOMY

Introduction: Hypocalcemia is a common complication following total thyroidectomy due to surgical injury to the parathyroid glands, leading to reduced parathyroid hormone (PTH) secretion. Early detection of hypocalcemia is crucial to prevent morbidity and enable timely intervention.This study assesses the predictive value of 1-hour post-thyroidectomy PTH (PTH-1) in identifying hypocalcemia. Objective: To compare ionized calcium (Ca²⁺) levels with PTH levels at 1, 6, and 24 hours after surgery. and assess the reliability of PTH-1 as an early indicator of hypocalcemia. Methods: This prospective study included 30 patients undergoing total thyroidectomy at KVG Medical College and Hospital between May 2023 and July 2024. PTH and calcium levels were measured at 1, 6, and 24 hours postoperatively. Patients were monitored for clinical and biochemical hypocalcemia. Statistical analysis determined the sensitivity, specificity, and predictive values of PTH-1 for hypocalcemia Results: Out of 30 patients, 25.7% developed biochemical hypocalcemia (Ca²⁺ <1.1 mmol/L) within 24 hours. PTH-1 demonstrated 89% sensitivity and 100% specificity in predicting hypocalcemia. Patients with PTH-1 <1.5 pmol/L were at high risk and benefited from early intervention with calcium and calcitriol supplementation, preventing symptomatic hypocalcemia.Conclusion:The study emphasizes PTH-1 as a dependable early indicator of hypocalcemia after total thyroidectomy. Prompt calcium and calcitriol therapy based on PTH-1 levels reduces postoperative complications and facilitates safe early discharge for eucalcemic patients. Routine PTH-1 monitoring should be considered as a standard practice to optimize patient outcomes after thyroid surgery